INSIDE LOOK:

THE DAY-TO-DAY OF AN ADULT SURGICAL INTENSIVE CARE UNIT NURSE

Date Published: June 7, 2017

Meet Kelley Murphy, RN, BSN. Kelley not only takes on the role of registered nurse in the surgical intensive care unit (SICU)/ cardiovascular thoracic intensive care unit (CVTICU), but she also takes on the role of full-time student pursuing a doctorate of nursing practice to become a family nurse practitioner. She breaks down the steps she took as a new nurse to get to this point, plus a lot of a great advice.

Tell us about your background as a nurse.

After graduating with my BSN from Saint Mary’s College in Notre Dame, IN, I moved to Chicago and took a Med-Surg RN position at Rush University Medical Center (RUMC). After 18 months of gaining critical assessment skills on the floor, I obtained an ICU position in the Surgical and Cardiovascular Thoracic ICU at RUMC.

I worked in the ICU for two years then took a travel nurse assignment in San Diego, CA while maintaining my ICU position in Chicago. I was able to keep my ICU position in Chicago by dropping down to per diem (only required to work 16 hrs every schedule) and I would fly back to work my required hours!

Travel nursing is amazing! I loved it so much. I then went to Portsmouth, NH to see what the east coast had to offer! After working as an ICU travel nurse for nine short months, I am back in Chicago working in the SICU/CVTICU and am in school studying for a doctorate of nursing practice to become a family nurse practitioner.

What inspired you to become a nurse?

My great aunts were nurses and Sisters of The Daughters of Charity. Growing up hearing stories of their role as religious members in healthcare inspired me. Their love and compassion for caring for the sick moved me to become a nurse.

As an adult surgical ICU nurse, what does your typical day look like?

There is never a dull moment in the SICU/CVTICU. We receive critically unstable patients from the OR who undergo open heart, lung, gastrointestinal, and cardiovascular surgeries, as well as liver and kidney transplants, who often require intense monitoring and resuscitation. We also receive overflow patients from the neuroscience ICU, medical and cardiac ICUs.

The ICU culture is heavily based in teamwork. We are constantly working together and helping one another. We closely monitor our patients and notify the ICU residents and attendings of acute changes in our patients statuses. The ICU environment requires nurses to have focus, stamina, critical thinking skills, and practice effective communication. I love working in critical care because it is fast paced and always something new to learn.

What is the most exciting part of your job?

I really enjoy when patients come out of the OR very sick and require diligent critical care and then start to get better after several hours. I enjoy seeing these patients wake up after such extensive surgical procedures and see their health improve.

What is the toughest part of your job?

The toughest part of my job is being there for the family of the dying loved one. It is emotionally tough to help them cope with the situation while still caring for the patient in the bed. It is, however, rewarding to help both the patient and family through this process with the understanding that death is part of life.

I have been able to strengthen my critical thinking skills by keeping updated on the newest evidence based practices for ICU nurses through continuing education modules. Keeping myself well informed of the nursing policy and procedures at my institution as well as asking other nurses for assistance to help troubleshoot a patient case has helped strengthen the way I approach the tough moments in the ICU.

Which courses in nursing school helped you the most to prepare for this role?

All of my critical care classes helped with the transition to the critical care nursing role. The class and theory is important but I gained the most experience through my clinicals and the nurses I worked with as a student.

What advice would you give to a nursing student interested in joining an adult surgical ICU unit?

It is best to first master assessment skills and time management on a step-down or medical-surgical floor before entering the fast paced, high acuity critical care environment. Gaining confidence is priority as a new nurse, and the best way to do so is through experience.

You are also in nurse practitioner school, how do you balance both your role as a student and a working nurse?

Time management and planning ahead! To balance my two roles as a full-time nurse and full-time student is challenging at times, but the key is taking one day or one task at a time. Having good support from work and from family and friends is important to successfully balance work-life-school.

What made you decide to go to nurse practitioner school?

Working in the acute care setting has opened up many questions about preventative care, education, and primary care. Nurses in hospitals see so many people with preventable and chronic issues that are mismanaged due to lack of education and or primary care involvement. I want to continue to grow as a nurse and become a family nurse practitioner to be able to care for individuals across the lifespan in the primary care setting to help and educate them about their illness.

What advice would you give a nursing student who is also considering nurse practitioner school?

Go for it! Nurses have the opportunity to make a difference in primary care in our current healthcare system. Gain experience for several years and find what interests you most. There are so many avenues to explore as a nurse and advanced practice nurse from leadership, education, acute care, primary care, gerontology, pediatrics, and even anesthesia.